AB1107 COVID-19 INFECTION MAY BE TRIGGER FOR DEVELOPMENT OF IMMUNE-MEDIATED DISEASES (IMDs)
Authors: N. Manukyan, V. Vardanyan, K. Ginosyan, A. Sargsyan, S. Mardoyan
Journal: Annals of the Rheumatic Diseases (2022)

Background As considerable evidence indicates viruses play an important role in the pathogenesis of inflammatory rheumatic diseases as environmental factors. The most prominent pathogenic viruses which have been proposed in the triggering and initiation of autoimmune diseases include Parvovirus B19, Epstein-Barr-virus (EBV), Cytomegalovirus (CMV), Herpes virus-6, HTLV-1, Hepatitis A and C virus, and Rubella virus 1 . It is possible that COVID-19 infection is also a trigger. Because SARS-CoV-2 infection can break immune tolerance and trigger autoimmune responses, it is also likely to induce clinical autoimmunity 2 . Objectives Find out a possible association between Covid-19 infection and development of IMDs. Methods We analyzed data of 21 patients (Male 4 /19 %/, female 17 /81%/, mean age 45.5 ± 13,9 years), who were admitted to Rheumatology department of “Mikayelyan” University Hospital after Covid -19 infection with newly diagnosed IMDs from June till December 2021. All of included had never had such kind of disorder before. EULAR/ACR criteria were used for diagnosis and assessment of disease activity. Results After SARS-CoV-2 infection some patients presented with preserved fever, high levels of CRP and ESR, had rash and arthritis. Particularly, 3 (14.3%) developed systemic lupus erythematosus, 3(14.3%) – antiphospholipid syndrome, 4 (19%) – rheumatoid arthritis, 2(9.5%) - spondyloarthritis, 3 (14.3%) - sarcoidosis, 4 (19%) - erythema nodosum, 1 (4.8%) - small-vessel vasculitis, 1 (4.8%) - undifferentiated arthritis, and 1(4.8%) - Tietze syndrome. 11 (52.4%) experienced severe course of Covid-19 with pneumonia and respiratory failure, in 10 (47.6%) patients the course of disease was mild. We’ve found a significant association between severe course of Covid-19 and development of erythema nodosum. (p&lt; 0.05). Also an association between female gender and severe course of Covid-19 was determined (p&lt;0,05). Conclusion In acute progression of the COVID-19 along with development of antiviral immunity, a dysregulated response of immune system may occur, represented by the marked cytokine release syndrome, macrophage activation, and systemic hyperinflammation. 3 We analyzed the data of patients who didn’t have any typical symptom of rheumatic diseases before coronavirus infection, therefor, on our opinion, virus played an important role to induce clinical autoimmunity and autoinflammation and subsequently – IMDs. Possibly, Covid-19 infection may be included in the group of trigger viruses for References [1]Ehrenfeld M, Tincani A, Andreoli L, Cattalini M, Greenbaum A, Kanduc D, Alijotas-Reig J, Zinserling V, Semenova N, Amital H, Shoenfeld Y. Covid-19 and autoimmunity. Autoimmun Rev. 2020 Aug;19(8):102597. doi: 10.1016/j.autrev.2020.102597. Epub 2020 Jun 11. PMID: 32535093; PMCID: PMC7289100. [2]Liu Y, Sawalha AH, Lu Q. COVID-19 and autoimmune diseases. Curr Opin Rheumatol. 2021 Mar 1;33(2):155-162. doi: 10.1097/BOR.0000000000000776. PMID: 33332890; PMCID: PMC7880581. [3]Novelli L, Motta F, De Santis M, Ansari AA, Gershwin ME, Selmi C. The JANUS of chronic inflammatory and autoimmune diseases onset during COVID-19 - A systematic review of the literature. J Autoimmun. 2021 Feb;117:102592. doi: 10.1016/j.jaut.2020.102592. Epub 2020 Dec 14. PMID: 33401171; PMCID: PMC7833462. Disclosure of Interests None declared